Provider Demographics
NPI:1275807034
Name:HARVARD NUTRITION COUNSELING
Entity Type:Organization
Organization Name:HARVARD NUTRITION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DONELAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:978-273-9524
Mailing Address - Street 1:149 BEL AIR DR
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-6157
Mailing Address - Country:US
Mailing Address - Phone:978-273-9524
Mailing Address - Fax:
Practice Address - Street 1:233 AYER RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1131
Practice Address - Country:US
Practice Address - Phone:978-273-9524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA541133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty